Update to Review Choice Demonstration: Removal of Choice 3

July 2024

The Review Choice Demonstration (RCD), implemented by the Centers for Medicare and Medicaid Services (CMS), ensures proper documentation and compliance with home health policies. It utilizes a flexible and choice-driven approach for home health agencies to reduce improper payments and improve overall service. Providers in the demonstration states of North Carolina, Ohio, Florida, Texas, and Oklahoma could previously select from three initial choices. However, CMS recently decided to remove Choice 3.

CMS Removes the Choice 3 Option

When CMS announced a five-year extension to the RCD, which took effect on June 1, 2024, they also revealed their decision to remove Choice 3: Minimal Review with 25% Payment Reduction from the initial choice selections. Therefore, providers must now make new review choice selections in coordination with Palmetto GBA.

  • Pre-Claim Review
  • Post-Payment Review.

The removal of Choice 3 may require home health agencies to adapt their billing processes and confirm that they have sufficient documentation to support their claims. Providers who do not choose an initial review option will automatically be enrolled in Choice 2: Postpayment Review.

Navigating the CMS Updates with Cliniqon

CMS frequently updates its policies and reimbursement structures to improve the quality of healthcare delivery and reduce costs. This can be challenging for home healthcare providers, who must stay current with these changes to ensure compliance and maintain their reimbursement rates.

Cliniqon specializes in assisting home health providers with navigating regulatory changes, such as those related to the Review Choice Demonstration. The recent removal of Choice 3 requires providers to adapt quickly and choose the best review option. We offer support to help providers implement these updates effectively while ensuring seamless and compliant operations for your home health agency.